Diagnosis and Management of AVM with the Swedish Vascular Malformation Center, Denver

AVMs constitute some of the most difficult diagnostic and therapeutic dilemmas in the practice of medicine. In fact, most physicians are inexperienced in both the detection and treatment of AVMs, due to the rare presence of such defects in patients. Ironically, most AVMs are discovered during an autopsy or in the treatment of an unrelated diagnosis.

Finding the Correct Diagnosis for AVM

Dr. Yakes uses magnetic resonance imaging (MRI) to confirm the presence of the defect, as well as the emerging success of Color Doppler imaging (CDI). For an experienced physician like Dr. Yakes, one of the more distinctive signs indicating the presence of an AVM is an auditory phenomenon called a "bruit" – a rhythmic, whooshing sound caused by excessively rapid blood flow through the arteries and veins of an AVM.

Because AVM symptoms can be mistaken for other health-related problems, patients are often misdiagnosed and frustrated by consulting with multiple physicians to determine the root of the problem. Even at birth, babies can be misdiagnosed when a physician mistakes an AVM for a condition known as pediatric hemangioma, the most common type of tumor of infancy.

Non-Invasive Surgical Treatment Often a Cure for AVM

Dr. Yakes has been a leader in the diagnosis and management of AVMs for three decades, even pioneering an innovative and curative approach to treatment. This non-invasive surgical approach relies on a catheter and absolute ethanol (ethyl alcohol) embolotherapy to achieve a permanent result in ridding an individual of an AVM. Specifically, alcohol not only causes clots to form in these abnormal circulatory lesions, it destroys the cells that line the blood vessel so that recurrence is not possible. While the use of alcohol is considered risky for the inexperienced physician, Dr. Yakes’ extensive experience has earned him some of the highest cure rates in the world. In fact, more than 90 percent of the patients coming to the Vascular Malformation Center at the Colorado Neurological Institute (CNI) at Swedish Medical Center are from out of state.

In the last decade at the CNI, Dr. Yakes and his staff has used this highly successful non-invasive surgical method for treating AVMs of the brain in particular. The brain is one of the most unforgiving of territories and Swedish Medical Center’s experience has allowed its safe use time and time again, with a cure rate of more than 85 percent.

Not only do patients come from all over the world, but Dr. Yakes draws medical peers from around the globe as well. Physicians come to Denver to learn from Dr. Yakes and then take that knowledge to Japan, South Korea, Australia and New Zealand. Dr. Yakes is helping to establish a center in Hong Kong, and has already established centers in Spain, Hungary, Italy, France, Holland, Sweden and Iran.